Monthly Archives: June 2012

No Such Thing as a ‘Normal’ Vagina?

2012-06-25

Perhaps it need not be said that one vagina is not the same as the next, but medically speaking, doctors have long thought that all “healthy” vaginas had certain things in common — namely levels of some good bacteria.

But a new study led by Jacques Ravel at the University of Maryland School of Medicine reports that in fact not all women are created equal. The vaginal microbiome — the community of bacteria living in the vagina — varies considerably between women, the study found, and even within the same woman at different times.

The results, published this week in Science Translational Medicine, suggest that there may not be a single standard for a “normal” or “healthy” vaginal environment. Levels of bacteria that may signify bacterial infection in one woman may be healthy in another. The study involved 32 women who submitted vaginal bacterial swabs taken twice a week for 16 weeks.

How Will You Really Feel During Depression Treatment?

If you’re taking an antidepressant to treat depression—whether it’s for the first time, you’ve recently changed medications, or you’re experiencing a repeat episode of depression—you’re looking forward to feeling like your old self again. And chances are good that eventually, you will.

But it’s important to be realistic about how you’re likely to feel these first few weeks. Otherwise, you might get discouraged and give up before treatment has a chance to work.

“When side effects occur, the vast majority arise early in treatment,” says Rajnish Mago, M.D., director of the Mood Disorders Program at Thomas Jefferson University in Philadelphia. “Most tend to diminish within a few days or weeks.” And although they may be a nuisance, most are not medically dangerous.

If you aren’t feeling any better at all within a month, your doctor may adjust your treatment by changing the dose of your medicine, switching to another medication, or adding psychotherapy or a second medicine to the mix.

Social media for two…

Facebook recently made headlines twice – first, when the company went public and again, when founder Mark Zuckerberg tied the knot. Although Facebook’s IPO was disappointing to those who had high expectations, we can hope at least that Zuckerberg’s marriage will soar, even if his stock did not.

One way the Zuckerbergs – and all couples – can help maintain a healthy connection with each other is to be cautious about the way they use Facebook and all social media, for that matter. As I’ve written before in this column, social networking tools can bring people together, but they can also pull couples apart. Think about it: You and your partner might be sitting next to each other on the couch or in bed, tapping away on your individual laptops, smart phones, or iPads, lost in a virtual world where flirting with a stranger, friend, or old flame is just a click away. In other words, you’re turning on social media—and maybe turning on to someone else, too—even as you tune each other out. From laptops, to smart phones, to tablets, today’s gadgets allow us to remain connected 24/7—yet that doesn’t necessarily mean that we are connected to our partner

How Feeling Lonely Can Shorten Your Life

2012-06-20

s loneliness lethal? According to two new studies published online Monday in the Archives of Internal Medicine, living alone or feeling lonely can increase your chances of disability and early death.

In one study, researchers at Harvard Medical School followed nearly 45,000 people who had heart disease or were at high risk of developing it. Over four years, the study authors tracked the participants’ health and found that those who lived alone were more likely to die from heart attack, stroke or other heart-related problems than those who lived with others.

The association was especially marked by age: for the youngest participants, aged 45 to 65, living alone increased the risk of early death by 24%; in people aged 66 to 80, solitary living was associated with a 12% increased risk of death; among those over 80, there was no link between living arrangements and risk of heart-related death.

5 Tips to Overcome Emotional Eating

2012-06-11

Could work stress be causing your expanding waistline? A recent Finnish study found that women who had job burnout were more likely to turn to food for comfort and to eat uncontrollably, compared with women who weren’t overworked. The study‘s authors suggested that obesity treatment should include evaluations of people’s work stress and emotional eating habits.

It’s not just a stressful workweek, but also a fight with the spouse, a visit with the in-laws or an all-around low mood that can make the chocolate ice cream beckon that much more seductively. “Stress, anxiety, depression, really any kind of strong emotion can trigger an emotional binge,” says Dr. Joy Jacobs, clinical eating disorder psychologist and assistant clinical professor at University of California, San Diego, School of Medicine. “Emotional eating happens whenever someone has an emotion they do not know how to handle, even happiness, and they channel it into an eating experience.”

A New Treatment For Curved Penis?

About 5% of men are plagued with a distressing condition called Peyronie’s disease — a painful curvature of the penis during erection that can make sex difficult or even impossible.

This week, a drug company promised them some relief: in trials, a drug called Xiaflex reduced the curvature significantly compared with placebo, and also helped men feel less troubled about their condition.

In one trial, average curvature went from 48.8 degrees to 31 degrees in a year, a 37.6 improvement, compared with a change from 49 degrees to 39 degrees in the placebo group, a 21.3% improvement. The treatment is no cure, but “it’s a major advantage over what we have now, which is nothing,” researcher Dr. Culley C. Carson III, a professor of urology at the University of North Carolina, told the New York Times.

If the drug is approved to treat Peyronie’s, it would be marketed to the estimated 65,000 to 120,000 American men who receive the diagnosis each year. Xiaflex’s maker, Auxilium Pharmaceuticals, said that approximately 5,000 to 6,500 of these men are currently treated with injectable therapies or surgery.

Xiaflex was approved in 2010 as treatment for Dupuytren’s contracture, a condition that causes fingers to remain clenched. Xiaflex is an enzyme called collagenase, which breaks down collagen, a key component of the connective tissue found in various organs, including the skin, tendons and cartilage. Both Dupuytren’s and Peyronie’s are caused by an excess of collagen that builds up in the hand or penis.

In Peyronie’s, the collagen contributes to plaques that cause the bent shape. Treatment could involve up to eight injections of Xiaflex into the plaque over a period of months; doctors would also help break up the plaque by hand. Side effects may include pain, swelling and clotted blood within the tissue. Auxilium hopes the treatment will be preferable to surgery — which can cause erectile dysfunction — for many men and doctors.

“Obtaining a statistically significant reduction in penile curvature deformity and improvement in Peyronie’s disease bother without the risks of surgical intervention represents an enormous advantage for eligible patients suffering from Peyronie’s disease,” Dr. Larry Lipshultz, professor of urology and chief of the division of male reproductive medicine and surgery at Baylor College of Medicine, said in a Auxilium statement.

(MORE: Add Inches!! (No, Really, Men Can Make It Longer))

Auxilium plans to file a supplemental Biologics License Application with the Food and Drug Administration within the year seeking approval for Xiaflex to treat Peyronie’s disease.

Which Birth Control Works Best? (Hint: It’s Not the Pill)

2012-06-07

Long-lasting contraceptives such as the intrauterine device (IUD) and implants are better at preventing pregnancy than more popular birth control methods, including the pill, patch and vaginal rings, a new study concludes.

The study involved 7,486 women participating in the Contraceptive Choice Project, run by researchers at Washington University School of Medicine in St. Louis. The women, aged 14 to 45, were given their choice of contraception for free and then tracked for up to three years for unintended pregnancy. The results, published in the New England Journal of Medicine, found that longer-lasting contraceptives were up to 20 times more effective — that is, women using IUDs, implants or hormone injections were up to 20 times less likely to get pregnant — after three years than the shorter-acting methods of birth control.

Among the 1,500 women who chose to use birth control pills, patches or vaginal rings, 4.8% became pregnant after one year, compared with only 0.3% of the nearly 5,800 women who chose IUDs or implantable contraceptives. After three years, 9.4% of women using short-acting contraceptives got pregnant, compared with 0.9% of those using longer-acting methods.

Women using hormone injections (a minority at 176) had even better success, with 0.1% becoming pregnant after one year and 0.7% becoming pregnant after three years.

The results, while striking, aren’t all that surprising, considering that shorter term options depend on consistent compliance to work most effectively: pills must be take daily and patches and rings must be replaced within days or weeks.

In contrast, IUDs, which are fitted into the uterus, last five or 10 years, depending on the device. Hormonal implants, which are surgically placed under the skin of the upper arm, are effective for three years. And injections last three months.

(MORE: The Pill at 50: Sex, Freedom and Paradox)

How well a birth-control method worked depended also on the age of the user: younger women, under 21, using pills, patches or vaginal rings were nearly twice as likely to become pregnant as older women who used the same contraceptives. Why? Because they were more likely to forget to take their pills or to change their patch or ring. There were no age-related differences in pregnancy rates among women using IUDs, implants or injections.

Overall, poorer women with less education were also more likely to experience contraceptive failures.

The researchers hope their results will prompt more women to consider using long-acting contraceptives to prevent unwanted pregnancy. Each year in the U.S., there are an estimated 3 million unplanned pregnancies, about 1.2 million of which lead to abortion, according to the study. About half of unintended pregnancies occur because of because of incorrect or inconsistent use of contraception, including condoms and birth-control pills.

Still, the pill is the most commonly used contraceptive in the U.S. That may be because women don’t hear about long-acting methods as often as other contraceptives, or because women are more comfortable taking a pill or using a patch than having a device implanted in their body. Another factor: cost. IUDs and implants are expensive and aren’t typically covered by insurance.

“Nationally, only about 5 percent are using long-lasting methods like IUDs and implants. We know one of the barriers to why they’re not using them more frequently is up-front costs,” the study’s lead author, Dr. Brooke Winner of Washington University School of Medicine, told Reuters. “If [more] women were using these products nationally, there would be a very significant drop in unintended pregnancies, which would have far-reaching effects.”

While longer-lasting contraceptives can be more expensive up front, they may turn out to cost about the same as the pill when the expense is broken down by day, the researchers noted. IUDs and implants can be removed when women wish to become pregnant, and fertility typically returns immediately.

The researchers hope their study will also encourage doctors to consider IUDs and implants when discussing birth control with their patients. “If there were a drug for cancer, heart disease or diabetes that was 20 times more effective we would recommend it first,” another study author, Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University, told the Wall Street Journal.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Should Depressed People Avoid Having Children?

2012-06-06

Comedian Sarah Silverman, who routinely courts controversy with her edgy humor, recently made an attention-getting statement of a more intimate nature: because of her personal and family history of depression, she declared that she would not have biological children, to avoid passing her mental problems to the next generation. “I don’t want kids,” she said on The Conversation with Amanda de Cadenet. “I know that I have this depression and that it’s in my family. Every family has their stuff but, for me, I just don’t feel strong enough to see that in a child.”

Pundits across the Internet praised Silverman for her honesty and sense of responsibility, duly citing research that shows that depression is deeply heritable. People with a parent or sibling with major depression are two to three times more likely than average to develop it themselves.

But what the commenters didn’t mention is that the same genes that can cause depression may also encourage the sensitivity and sensibility that gives Silverman her creative talent. Indeed, some research suggests that the same exact genetics that might lead to depression can also lead to mental superhealth, depending on whether a person endured high stress in early childhood or had a calmer, more nurturing environment.

(MORE: The Measure of a Mother’s Love: How Early Neglect Derails Child Development)

Atlantic writer David Dobbs has called such genes “orchid genes.” Like the finicky flowers, they thrive and outshine ordinary plants when grown in the perfect conditions, but otherwise rapidly wilt and die. In contrast, he describes “dandelion genes,” which allow healthy development, whether the setting is harsh or bountiful.

Some of the genes involved in risk for attention deficit hyperactivity disorder (ADHD), addiction and depression seem to share this quality, leading to vulnerability if early life is difficult but otherwise providing advantages. A recent study found also that people who had genes associated with better memory — a powerful aid to learning and intelligence — were more likely to suffer post-traumatic stress disorder after trauma, compared with those without the same genetic variants. People with better memories had more flashbacks.

Dobbs writes:

Focus on just the bad-environment results, and you see only vulnerability. Focus on the good-environment results, and you see that the risk alleles [or gene variants] usually produce better results than the protective ones. Securely raised 7-year-old boys with the DRD4 risk allele for ADHD, for instance, show fewer symptoms than their securely raised protective-allele peers. Non-abused teenagers with that same risk allele show lower rates of conduct disorder. Non-abused teens with the risky serotonin-transporter [gene variant] suffer less depression than do non-abused teens with the protective allele.

(MORE: Does A Better Memory Equal Greater PTSD Risk?)

Basically, whether a gene is “good” or “bad” depends on where it “lives” and how it is “raised.” And I would argue that even when people with orchid genes don’t have the benefit of a good early environment, their innate sensitivity to their condition can still often allow talent to flourish.

Artists and writers have long noted a correlation between mood disorders and creativity. A recent study of 300,000 Swedish families affected by psychiatric disorders found that people with bipolar disorder are overrepresented in creative professions. That same study showed that healthy relatives of people with schizophrenia are more likely to have creative careers, a finding that supports earlier research suggesting that the genes that lead to schizophrenia in certain conditions or combinations may produce heightened creativity in others.

A similar phenomenon can be seen in autism. Notoriously, many of the most successful people in computer science and engineering have traits similar to those seen in people with high-functioning autism — or they have the condition itself. Relatives of people with autism are more likely to be engineers, mathematicians or computer scientists, compared with the families of non-autistic people. One study found that students majoring in technical professions were more likely to have autistic relatives, while those majoring in humanities were more likely to have depressed, addicted or bipolar family members.

(MORE: Study: Some Autistic Brains Really Are Wired Differently)

This means that if you eliminate the genes that carry these mental-health risks, you may also do away with their associated benefits. The research suggests strongly that the genes associated with our most tragic psychological conditions may also carry the potential for our greatest talents and skills.

And so, while I wouldn’t presume to advise anyone about their personal reproductive decisions, I don’t think it’s necessarily “more responsible” for people with depression or other brain differences to forgo having children. Obviously, someone who cannot function due to psychiatric disease should not set out to become pregnant, and people whose conditions are untreatable or unbearable to them may want to prevent any possibility of passing on the same kind of suffering. But we should remember that, contrary to claims that the dark poet Sylvia Plath would have inevitably become insufferably twee if given Prozac, successfully treating depression or any such condition does not erase or eliminate genius, merely pain.

Consequently, as we as a society get better at identifying the genes that contribute to depressive, schizophrenic or autistic traits, we need to consider not just disabilities but potential. By selecting against our “worst” genes, we may run the risk of losing our greatest gifts.

MORE: The Perils of ‘Metabolic Chauvinism’

Maia Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.

Blessed Are the Sleek? Why God Wants You to Be Thin

2012-06-05

Let’s say you believe in God (most Americans do). Let’s say you’re deeply religious (most Americans say they are). So what does God want for you? You can be pretty sure God wants you to be happy, to be charitable, to be honest, to be kind. You can be pretty sure God doesn’t care if you’re rich, beautiful, famous or thin, right? Well, that thin part may take a little explaining.

With the U.S. tottering under an obesity epidemic that has left two-thirds of all adults and one-third of all kids overweight or obese, public health experts are despairing of finding new ways to get Americans off their duffs, away from the fridge and back into at least nominally healthy habits. Fad diets are useless; gym memberships do nothing — at least if they go unused; public service ads get ignored. But, as we explore in this week’s issue of TIME (available to subscribers here), where all of those efforts have failed, faith could succeed — at least according to Pastor Rick Warren.

Two years ago, Warren, the author of the über-bestseller The Purpose Driven Life and the leader of the Saddleback mega-church in Lake Forest, Calif., was struck by how out of shape his 20,000-strong congregation had gotten and, he readily admitted, he was no better, tipping the scales at 295 lbs. — or a full 90 lbs. too much for his 6-ft.-3-in. frame. He suspected he had a way to fix all that — one that might work in the wider world as well — and the secret, he believed, lay in Scripture, specifically in the Book of Daniel.

(MORE: The Book of Daniel: Is It Really About Diet?)

There’s a lot that happens in the Book of Daniel, but the critical passage occurs when Daniel and three other Jewish boys are brought to the court of the conquering King Nebuchadnezzar, where they are to be fed and trained so that they may serve in the royal circle. But as the Biblical passage recounts, the boys resist at least in part, refusing the rich foods of the king’s table and choosing a more spartan fare instead:

…Daniel resolved not to defile himself with the royal food and wine, and he asked the chief official for permission not to defile himself this way… “Please test your servants for ten days: Give us nothing but vegetables to eat and water to drink. Then compare our appearance with that of the young men who eat the royal food, and treat your servants in accordance with what you see.”

What the chief official saw, of course, was that Daniel and his friends had grown fitter and stronger than the other servants. It wasn’t vegetarianism or vigorous exercise that had worked that magic — though those were part of it. Instead, it was a belief that it was impossible to serve God fully if you were out of shape or unwell. For Daniel, getting fit was a triumph of faith — and Warren was convinced his church members could find motivation the same way.

With that was born the Daniel Plan, a sweeping program of smart eating (and yes, lean meats are included), workout classes, small-group support meetings, walk and worship sessions and more, much of it made available both in person and online. Warren recruited three marquee names from the world of medicine — Drs. Mehmet Oz, Daniel Amen and Mark Hyman (all of different faiths) — to help spread the good-health message, and the Saddleback members fell in love with the plan. More than 15,000 of them have signed up so far and in the past 18 months alone, they have lost a collective 260,000 lbs.

(MORE: Dr. Oz: How Faith and Health Go Hand in Hand)

The bigger question about the Daniel Plan is whether it could work in other churches — both evangelical and non-evangelical — not to mention in synagogues, mosques and other houses of worship. Warren is betting it can, and, according to Hyman, is considering rolling out the program to 1 billion people worldwide over the next decade. Non-believers may grumble at the religious component of the plan, and Warren himself has stirred controversy over time with the strictness of his evangelical teachings. But this mission may transcend all of that. “We all get sick, regardless of religion,” says Hyman. When it comes to getting well, he and others argue, we can’t be choosy about where we get our answers.

Stay-at-Home Moms Report More Sadness, Anger and Depression

2012-06-04

Not long ago, there was a dust-up when Democratic strategist Hilary Rosen accused Mitt Romney’s wife, Ann, of not fully comprehending this country’s economic issues because she had “never worked a day in her life.”

Ann Romney responded, on Twitter: “I made a choice to stay home and raise five boys,” she wrote. “Believe me, it was hard work.”

The controversy swirled for days: stay-at-home mothers — SAHMs — had been dissed, and they weren’t happy about it. Amid the political and cultural fall-out, Elizabeth Mendes, deputy managing editor of Gallup.com, was paying attention. Gallup.com surveys 1,000 Americans each day about topics that percolate to the top of the news cycle. The editorial team noticed that news about moms — the stay-at-home sort and the working variety — was hot. So they decided to train their sights on the maternal demographic.

“The discussion around Ann Romney and Hilary Rosen started a lot of conversations about the different types of groups of moms,” says Mendes. “We thought, What can we look at to see what’s going on with this population?”

What they found doesn’t bode well for the morale of the SAHM contingent, according to results released in May that hint at the possibility that women’s happiness just might depend on their employment status.

Gallup zeroed in on all kinds of metrics for health and well-being, comparing happiness, anger and sadness, among other feelings, in working moms and those who stayed at home, as well as in women who weren’t mothers.

Gallup looked first at categories including anger, worry, stress, depression, smiling and laughter. It found that non-working women with a child under 18 at home experienced more worry, sadness, stress and anger than moms who are employed full-time or part-time.

One of the most noticeable differences revolved around questions about depression. Gallup asked the women polled if they’d ever been diagnosed with depression and found that SAHMs were more likely to say yes than working moms. Of SAHMs, 28% reported receiving a diagnosis of depression at some point compared with 17% each for employed moms and employed childless women. “Moms who are employed, full-time or part-time, look more like the employed women group than SAHMs,” says Mendes.

So does the data suggest that employment is the key to happiness? Well, it’s true that employed moms experience fewer negative emotions than SAHMs, according to Gallup’s survey. “It’s certainly possible that it’s because they are working,” says Mendes.

Gallup also compared different income groups, splitting women into high-income, middle-income and low-income categories to explore whether finances played a role in mothers’ reported well-being. Across all three income groups, SAHMs did worse on measures of sadness, anger and depression than employed moms.

When Gallup looked at other measures of well-being — such as happiness, enjoyment, learning something interesting and stress — there were no significant differences between working moms and SAHMs in the middle- and high-income groups. But differences remained in the lower income groups. “In general, we know that a very high percentage of Americans report happiness,” says Mendes. “So it might be endemic.”

Says Mendes: “This suggests there might be something about working that is creating more positive emotions for employed moms, or there might be something about staying at home that’s creating more negative emotions,” says Mendes.

This is not the first survey to conclude that working serves moms best. In December, a study in the Journal of Family Psychology found that working moms are healthier and happier than mothers who stay at home when their children are babies and preschoolers. On the other hand, 2009 figures from the Pew Research Institute reflect a different reality. An equal number of SAHMs and working moms — 36% — reported feeling “very happy.”

So much for the mommy wars. At least as far as U.S. kids are concerned, the finding that moms who work for pay and those who don’t are equally content is a really good thing.

Bonnie Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.